Prioritization of neurologic rehabilitation interventions by ELECTRE-III analysis in subacute stroke patients

Turkmen C., KONCA M., YETİM B.

ACTA NEUROLOGICA BELGICA, vol.123, no.1, pp.181-189, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 123 Issue: 1
  • Publication Date: 2023
  • Doi Number: 10.1007/s13760-022-01982-5
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.181-189
  • Keywords: Decision-making, Innovative therapies, Neurological rehabilitation, Stroke, Upper extremity, INDUCED MOVEMENT THERAPY, UPPER EXTREMITY, BOBATH CONCEPT, IMPAIRMENT, RECOVERY, MIRROR
  • Hacettepe University Affiliated: No


Background Elimination and Choice Translating Reality (ELECTRE) III is a commonly used multicriteria decision-making (MCDM) method when alternatives are being prioritized in health sciences. The selection of the rehabilitation approach is the key factor to improve the upper extremity functions of stroke patients. Thus, choosing a reasonably good treatment approach will directly reduce the patient's cost to the government and caregivers, while also improving quality of life. The aim of our study was to prioritize the six different methods used in the rehabilitation of stroke patients with mild or moderate upper extremity dysfunction, using one of the MCDM methods based on experts' opinions. Methods A three-stage face-to-face interview across Turkey, based on the ELECTRE-III method, was conducted with 18 physiotherapists specializing in the rehabilitation of mild or moderate stroke-induced upper extremity disorders. Results According to ELECTRE-III, Circuit Class Therapy (CCT) is the best choice for treating upper extremity functional loss in general. It is also the best alternative in both the ascending and descending distillation processes of ELECTRE-III. On the other hand, Bobath neurodevelopmental treatment (NDT) has a similar success level according to ascending distillation. Mirror therapy and constraint-induced movement therapy are the third-best methods in the analysis. However, robotic rehabilitation is the least preferable treatment method according to the experts' judgments. Conclusions The results showed that rehabilitation interventions such as Bobath-NDT and proprioceptive neuromuscular facilitation, which are frequently used in developing countries, are still useful, and CCT is the most appropriate intervention for the transition from conventional methods to innovative models in these countries.